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川崎病临床特征及相关影响因素的回顾性分析。

Retrospective analysis of clinical characteristics and related influencing factors of Kawasaki disease.

机构信息

Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui China.

出版信息

Medicine (Baltimore). 2022 Dec 30;101(52):e32430. doi: 10.1097/MD.0000000000032430.

Abstract

To compare the clinical characteristics of complete Kawasaki disease (KD) and incomplete Kawasaki disease (IKD), and analyze the possible risk factors of coronary artery lesion (CAL) in KD. The clinical data of 139 children with KD admitted to the hospital from January 2016 to June 2022 were analyzed retrospectively. The differences of clinical characteristics between children with KD and children with IKD were compared. The risk factors of CAL were analyzed using univariate and multivariate logistic regression. Comparison of clinical characteristics between KD and IKD groups, the results showed there was significant difference in terms of conjunctival congestion, rash, lymph node enlargement, hand and foot redness, intravenous immune globulin non reaction and fever time (P < .05). Comparison of laboratory indicators between 2 groups, the results showed that there was significantly difference in the levels of neutrophils (P < .05). 15 cases (15.31%) in KD group were complicated with CAL, and 17 cases (41.46%) in IKD group were complicated with CAL, and the results showed there was a significant difference between the 2 groups (P < .05). Univariate analysis showed that the age and Hb of children with CAL were lower than those of children with nCAL, while C-reactive protein, NT-proBNP, NEUT, and ESR were higher than those of children with nCAL (P < .05). Multivariate analysis showed that the increase of NT-proBNP and the decrease of Hb may be independent risk factors for the occurrence of CAL in children with KD. The clinical manifestation of children with IKD is not typical. Compared with KD children, the fever time is longer and the incidence of CAL is higher. Under-age, increased NT-proBNP and decreased Hb may be independent risk factors for CAL in KD children.

摘要

目的

比较完全川崎病(KD)与不完全川崎病(IKD)的临床特征,并分析川崎病(KD)患儿冠状动脉损伤(CAL)的可能危险因素。

方法

回顾性分析 2016 年 1 月至 2022 年 6 月收治的 139 例 KD 患儿的临床资料,比较 KD 组与 IKD 组患儿的临床特征差异,采用单因素和多因素 logistic 回归分析 CAL 的危险因素。

结果

KD 组与 IKD 组患儿在结膜充血、皮疹、淋巴结肿大、手足红斑、丙种球蛋白无反应和发热时间方面比较,差异有统计学意义(P <0.05)。两组患儿实验室指标比较,中性粒细胞水平差异有统计学意义(P <0.05)。KD 组 15 例(15.31%)并发 CAL,IKD 组 17 例(41.46%)并发 CAL,差异有统计学意义(P <0.05)。单因素分析显示,CAL 患儿的年龄和血红蛋白水平低于非 CAL 患儿,而 C 反应蛋白、N 末端脑利钠肽前体、中性粒细胞、红细胞沉降率高于非 CAL 患儿(P <0.05)。多因素分析显示,NT-proBNP 升高和血红蛋白降低可能是 KD 患儿 CAL 发生的独立危险因素。IKD 患儿临床表现不典型,与 KD 患儿相比,发热时间更长,CAL 发生率更高。年龄较小、NT-proBNP 升高和血红蛋白降低可能是 KD 患儿 CAL 的独立危险因素。

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